Fungal Ulcer Treatment Augmented With Natamycin and Cyclosporine A
University of California, San Francisco
150 participants
Sep 1, 2025
INTERVENTIONAL
Conditions
Summary
The goal of this clinical trial is to learn if adjunctive topical Cyclosporine A eye drops combined with standard of care topical Natamycin treatment improves vision outcomes in patients with fungal keratitis.
Eligibility
Inclusion Criteria5
- Inclusion is based on presenting acuity, not ulcer size.
- Inclusion of 20/40 = 6/12 = 0.3 Log MAR and 20/400 = 3/60 = +1.3 Log MAR.
- Smear or culture positive for fungal keratitis, any length.
- Age 18 years.
- Willing to participate in study.
Exclusion Criteria10
- Co-infection with bacterial or viral keratitis.
- Corneal perforation.
- Requiring therapeutic keratoplasty for fungal keratitis.
- Unwilling or unable to follow up (e.g., living too far from hospital).
- Presenting acuity better than 20/40 = 6/12 = 0.3 Log MAR or worse than 20/400 = 3/60 = +1.3 Log MAR.
- Subjects taking cyclosporine at any concentration on presentation.
- Acuity worse than 20/200 = 6/60 = +1.0 Log MAR in unaffected eye.
- Pregnant women.
- Penetrating Keratoplasty.
- Presents with a 0-7 day history of topical steroid.
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Interventions
Participants with smear or culture proven fungal keratitis are treated for a minimum of 48 hours with topical natamycin and then randomized in a 1:1:1 ratio to receive either topical Cyclosporine A (CsA) 0.1%, 2% or placebo for 4 weeks. Natamycin is continued until the ulcer has healed.
Participants with smear or culture proven fungal keratitis are treated for a minimum of 48 hours with topical natamycin and then randomized in a 1:1:1 ratio to receive either topical Cyclosporine A (CsA) 0.1%, 2% or placebo for 4 weeks. Natamycin is continued until the ulcer has healed.
Locations(2)
View Full Details on ClinicalTrials.gov
For the most up-to-date information, visit the official listing.
NCT06658002